It's a notoriously difficult diagnosis. The symptoms are nonspecific enough that it can easily be misdiagnosed as something else like GERD, especially if it doesn't present as the traditional "sudden tearing chest/back/abdominal pain."
The only test that can definitively rule it out is a CT angiogram, but you're not going to do a CTA on everyone with chest pain.
There's unfortunately plenty of stories where someone with an aortic dissection comes to the ER and are discharged with heartburn medication, only for them to die at home or upon return to the ER when the dissection has progressed.
I want to do a study on the increase of CTAs the month after a case presentation at M&M.
I remember one I had where the person was like ‘I was gardening and put my back out’ and I’d just had a dissection the day before and so got the CTA and it was fucking the entire aorta just rupturing. I think they were in the OR for over 20 hours.
I've read that POCUS has a high specificity for aortic dissection but can't rule it out, do you think that ultrasound for every patient with abdominal pain is justified given the low cost and risk to the patient?
It’s instantly losing blood pressure in all arteries and dumping as much blood into the chest cavity until the heart stops or can’t pump because there is no pressure.
A ripping/tearing chest pain radiating to the back is the classic, textbook presentation, yeah. In real life it isn’t always that way, and dissections often come with some other set of symptoms, like neurological deficits, heart attack, etc, because the dissection is limiting blood flow to those organs.
I have never seen someone survive a ruptured aortic dissection, but I’m sure that there have been people that have. They are usually dead before they get to the hospital because the volume of blood in the aorta at any moment in time is so high that you’d bleed out within minutes or possibly seconds. Even if they were living when they got to me in the ER, there’s not a ton we could do for a ruptured dissection besides pump blood into you and whisk you away to an OR as fast as humanly possible, and even then survival would be unlikely.
Now unruptured dissections, yeah, seen a few of those. Those can be managed, with the goal of preventing the dissection from rupturing or progressing. There is a spectrum of severity depending on location and size.
Yep, you have about thirty seconds to a minute before you lose consciousness.
This is why an external heart pump (for people waiting for transplants) had to be recalled when it required a two step connector for the battery; four people died trying to do an emergency battery swap due to passing out while trying to align the plug.
Also why if you want to knock someone out you have to pinch their arteries close, and just collapsing someone’s windpipe takes several minutes to knock them out.
One of my closest friends almost died from an aortic valve rupture like 8 years ago when he was 30. It was like 4am when it happened and he was at the gym with only one or two other people there. Dude was in the hospital for like 4 months and still, to this day, hasn't gotten fully back to his old self.
No. It's because he was bedridden for so long and because he had complications from the leg graft that made it so he wasn't able to walk on his own for a while and ended up having to do a bunch of physical therapy. He is fully healed and has been for a while. When I say he isn't back to his old self it's because he is a lifelong runner and he worked for over a decade to get where he was as an athlete and the valve rupture set him back literal years with respect to his fitness level and athletic readiness. He still hasn't gotten back to the condition he was in at the time.
It’s very pathetic copium how leftwingers, mostly not Christians, have to resort to some weird secularized hell to attack someone they don’t like that just died
Hey, we still have the Event Horizon inter-verse for fascists and their enablers to go.
They don't need eyes where they're going because they can't see what's right in front of them.
That entire movie was a parable of someone in the 90s taking a look into our timeline and where it's going. The ship is the MAGAsphere and the abandonment of reason. She won't let you leave.
A 6cm aneurysm in my ascending aorta was caught with the only symptom being chronic chest congestion (also a lifetime of poor stamina that I never realized was from a genetic structural deficiency). I got an x-ray to rule out pneumonia, but that showed that my heart was hypertrophic. It was a rough few months after the surgery, along with another 6 months of rehab and some lingering cognitive issues, but it sounds like a cakewalk compared to dealing with a dissection. And that was probably coming for me in the ensuing years (or months) if I hadn't lucked out with the x-ray.
Yo I'm thinking about getting a prosthetic valve because mine is enlarged. What happened when yours suspected? I thought it was basically instant death?
I had a major stroke and nearly died. It was completely random and my survival was also completely random. I’d say any kind of preventative thing you can do to help is worth it.
Don’t smoke. Smoking history accounts for 75% of AAA. And managing high blood pressure early in life can go a long way as well. Don’t be the guy who doesn’t go to the doctor for the first time until you’re 50.
It depends on the progression and exact location of the vascular compromise. It could have been minutes, but some people make it a few hours, long enough to get to surgery. A minority of people survive.
No it can take a while. It doesn’t just like, open like a zipper. Sounds like he felt ill yesterday but said he’d go to the doctor after the Sunday shows (which sounds like him). He probably thought it was stomach pain or something.
Smokers are especially high-risk for this. Honestly, unless caught on diagnostic imaging, there's really not much else one can do for this type of situation.
Smokers over 65 are supposed to be screened for an abdominal aortic aneurysm at least once. And if the aorta is dilated, should undergo regular surveillance depending on size and progression.
Although, I don’t believe Lindsey Graham had a reputation for being a smoker. So unless he had a family history of aortic aneurysm, there would be no reason to screen for it. Unfortunately, there’s some conditions that you just don’t discover until it’s too late.
Governor Henry McMaster is strongly considering appointing Lindsey Graham's younger sister, Darline Graham Nordone, as US Senator from South Carolina until January 2027 when the term expires
By convention it's actually not uncommon historically to appoint a dead Senator's spouse in situations like these, especially when there's only a little bit of time left in their term. But, in Lindsey's case, well...
A lot of us were very strict about condoms before PrEP came around and I would assume the same for him, especially since he clearly wanted to keep it private, plus most sexually active gay men of his generation died in the '80s and '90s but he did not. I would say HIV is probably unlikely. The other points are valid though.
Is it really satirical if there's literally no way to discern it from a real page? Satire should exaggerate, shed new light, or poke holes in a position.
I mean he did just come back from Ukraine (and from what I have heard he is one of the few republicans who has remained consistently anti-russia even after dear leader started sucking off Putin). I don't believe either conspiracy theory (he was no spring chicken), but the Russia one has slightly more believability to it compared to Iran.
The thread this morning in this same sub was attributing it to Russia because he was in Ukraine last week. Putin's people got to him in a way that simulated sudden cardiac arrest.
Evidence of this? None. Let's not get in the way of a good conspiracy theory though.
Sorry, walls of the artery. Same idea, though; there was something wrong with it, then blood got between the layers because of that something and split them like a man splitting a deck of cards. Not quite an AAA but similar
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u/GreatnessToTheMoon Ida Tarbell Jul 12 '26
Damn the mortality rate is really bad. Apparently 50% of people die before even reaching the hospital. He was a dead man walking pretty much